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. 2021 Oct 30;4:100127. doi: 10.1016/j.cpccr.2021.100127

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© 2021 The Author(s)

Since January 2020 Elsevier has created a COVID-19 resource centre with free information in English and Mandarin on the novel coronavirus COVID-19. The COVID-19 resource centre is hosted on Elsevier Connect, the company's public news and information website. Elsevier hereby grants permission to make all its COVID-19-related research that is available on the COVID-19 resource centre - including this research content - immediately available in PubMed Central and other publicly funded repositories, such as the WHO COVID database with rights for unrestricted research re-use and analyses in any form or by any means with acknowledgement of the original source. These permissions are granted for free by Elsevier for as long as the COVID-19 resource centre remains active.

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Fig. 1. — 62-year-old woman with a history of metastatic breast cancer. Each row represents PET/CT exams from top to bottom, dating from January, April, July, and September 2021. Each column represents axial PET, CT, fused PET/CT, and coronal MIP images from left to right. Initially, in January, the patient presented with a right scapular hypermetabolic bone lesion (green arrows), which later biopsy-proven as metastasis from breast cancer. MIP images show a mildly metabolic new nodule in the left lung (purple arrow). In April, two weeks after COVID-19 vaccine, the scapular lesion improved (green arrows) following treatment with chemotherapy, but there were new hypermetabolic right axillary lymph nodes (blue arrows). Lung nodule was stable (purple arrow). In July, the lymphadenopathy completely resolved, consistent with vaccine-related reactive lymphadenopathy, and there was further decreased size and metabolic activity of the scapular lesion (green arrow). The lung lesion was slightly more conspicuous (purple arrow). In September, while under chemotherapy, the right scapular lesion was more improved (green arrows). However, the known left lung nodule was increased in size (purple arrow), and there was new right axillary hypermetabolic lymphadenopathy (blue arrows). Chart review showed that the patient had her third vaccine one day ago; thus lymph nodes were more compatible with vaccine-induced reactive lymph nodes. Wedge resection of the lung nodule confirmed osteosarcoma metastasis.